By the late 1990s, however, Malawi was reeling from the AIDS epidemic. As if that weren't bad enough, the government also had to cut spending on health care and education as a condition for getting help from the U.S. and other countries to liberalize its trade and economy.

The publicly funded health system, on which more than 95 percent of Malawians still depend for treatment, quickly started to fall apart.

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The money was to be used to pay higher salaries to nurses -- quite a radical move in global development as donors worry it is unsustainable in the long haul.

However, the situation in Malawi was getting desperate.

The gamble paid off: The number of registered nurses leaving Malawi fell from a high of 111 (the equivalent of two years of Malawi's entire nursing graduates) in 2001 to just six in the first half of 2008. Enrollment at Malawi's nursing schools jumped up by 50 percent.

Success in one area has revealed a different problem -- that of an internal brain drain.

As more international aid groups and universities set up health programs in Malawi, they are hiring nurses, all trained at Malawi taxpayer expense, away from publicly funded hospitals and clinics.

The problem is even more acute in the rural areas, where most of Malawi's people live.

Embangweni Mission Hospital in northern Malawi has a good reputation but is located at the end of a long, dusty road, far from major towns, let alone cities.

"Young nurses with families do not really want to work here," said Catherine Mzembe, head of nursing at Embangweni.

"The local market is very small and although the hospital has running water, that is not the case in many homes."

Even so, the hospital has made impressive strides in the past five years preserving mothers' lives during pregnancy, as well as cutting the number of deaths due to malaria among children and adults.

And that is perhaps the most important lesson to draw from Malawi's efforts: it pays to look at how much has been accomplished with so little.